The latest in nuclear oncology: Highlights from EANM’25

The 38th Annual Congress of the European Association of Nuclear Medicine (EANM) in Barcelona brought together over 9,400 participants, marking a major milestone. The meeting highlighted major advances in oncologic imaging and theranostics, with a strong emphasis on precision medicine and combination treatment strategies. Across plenary sessions, debates, and late-breaking discussions, the meeting underscored how nuclear medicine is increasingly central to cancer diagnosis, treatment selection, and therapeutic delivery.

Plenary highlights: The rise of targeted alpha therapy

Speakers: Prof. Mike Sathekge, Prof. Désirée Deandreis, Prof. Tadashi Watabe

Targeted alpha therapy (TAT) emerged as one of the most transformative themes in oncology. Prof. Mike Sathekge described alpha therapy as a distinct modality characterized by high linear energy transfer and potent, localized tumor cell killing. He highlighted clinical activity across prostate cancer, neuroendocrine tumors, and thyroid cancer, supporting its role in advanced disease settings. Prof. Désirée Deandreis expanded on the radiobiology of alpha emitters, emphasizing their ability to overcome radioresistance through dense DNA double-strand breaks and discussing their potential role in micrometastatic and immunogenic tumor niches. Prof. Tadashi Watabe presented early clinical data on astatine-211 in radioiodine-refractory thyroid cancer, demonstrating encouraging safety and early efficacy signals in first-in-human studies. Collectively, these presentations positioned alpha therapy as a high-precision approach for resistant and low-volume metastatic disease.

PSMA-targeted therapy and combination strategies

Speaker: Prof. Grace Kong

Prof. Grace Kong presented advances in PSMA-targeted radioligand therapy (RLT), emphasizing the limitations of monotherapy in heterogeneous prostate cancer. Combination strategies with androgen receptor inhibitors, chemotherapy, and immunotherapy showed improvements in progression-free survival, PSA response, and quality of life in Phase II studies. Alpha-emitting agents and sequential alpha/beta strategies were highlighted as promising approaches for resistant or micrometastatic disease. Molecular imaging (PSMA PET ± FDG PET) alongside biomarkers and genomic profiling was emphasized as central to optimizing patient selection and treatment sequencing. This work reflects a clear shift toward multimodal, biomarker-driven theranostics.

Integrating imaging and genomics for precision oncology

Speaker: Dr. Heather Jacene

Dr. Heather Jacene highlighted the integration of molecular imaging with genomic profiling to refine precision oncology. Circulating tumour DNA (ctDNA) and mutations in genes such as TP53, PTEN, and RB1 were associated with outcomes in PSMA-targeted therapy cohorts. In neuroendocrine tumors, genomic tools such as NETest and PRRT Predictive Quotient (PPQ) are being used to guide PRRT selection and monitor response. DNA damage repair alterations were shown to influence outcomes and may inform combination strategies, including PARP inhibition.

Radium-223 and optimization of bone-targeted therapy

Speaker: Prof. Elba Etchebehere

Prof. Elba Etchebehere presented long-term experience with radium-223 in metastatic castration-resistant prostate cancer. Phase II and III data confirmed overall survival benefit and reduced skeletal events. Real-world evidence demonstrated improved outcomes with full cycle completion and optimized dosing intervals. Combination with bone-protective agents and systemic therapies enhanced both efficacy and tolerability. Her presentation reinforced radium-223 as a foundational bone-targeted radionuclide therapy requiring optimal sequencing and dosing strategy.

Expanding theranostics beyond prostate cancer

Speakers: Prof. Mike Sathekge, Prof. Grace Kong, Prof. Tadashi Watabe

Across multiple presentations, theranostic approaches were shown to be expanding beyond prostate cancer. Prof. Sathekge and colleagues demonstrated activity of alpha and beta therapies across neuroendocrine and thyroid malignancies. Prof. Kong highlighted neuroendocrine tumor management with 177Lu-DOTATATE and evolving combination strategies. Prof. Watabe described radioiodine-refractory thyroid cancer as a key frontier for next-generation alpha therapy. These developments demonstrate the broadening clinical footprint of theranostics across multiple tumor types.

Conclusion

EANM’25 showcased a clear shift in oncology toward precision-guided, biomarker-informed theranostics. Key advances included the clinical maturation of targeted alpha therapy, the evolution of combination PSMA radioligand strategies, and the integration of imaging with genomics. Established radionuclide therapies such as radium-223 remain central, but are increasingly being optimized within multimodal treatment frameworks. Together, these developments highlight a future in which nuclear medicine plays a central role in personalized, mechanism-driven oncology care.

If you would like to learn more, please make sure to register for the EANM’26 Congress (October 17-21, 2026, in Vienna, Austria), here.

References

1. European Association of Nuclear Medicine. EANM’25 Scientific Highlights Report (PDF; October 2025)

About the European Association of Nuclear Medicine

The EANM is the leading professional society for nuclear medicine in Europe, bringing together clinicians, scientists, and allied professionals working in molecular imaging and radionuclide therapies. Its aim is to advance the science, education, and clinical application of nuclear medicine to improve patient care. The society promotes research, sets standards for practice, supports training and accreditation, and fosters collaboration across disciplines and countries to accelerate innovation in diagnostic imaging and targeted therapies.